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Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 Jan;33(1):13-17

Department of Orthopaedics, the First Affiliated Hospital of Fujian Medical University, Fuzhou Fujian, 350005, P.R.China.

Objective: To analyse the effectiveness of unicompartmental knee arthroplasty (UKA) for the patients with spontaneous osteonecrosis of the knee (SONK).

Methods: Between January 2012 and December 2016, 31 patients with SONK was admitted and treated with medial UKA. All patients were examined by both plain radiography and magnetic resonance images. Read More

Rheumatol Int 2019 Jan 17;39(1):153-159. Epub 2018 Dec 17.

Division of Rheumatology, Department of Internal Medicine, Gazi University Faculty of Medicine, 06100, Ankara, Turkey.

Avascular necrosis (AVN), also known as osteonecrosis, is characterized by death of the osteocytes due to inadequate blood supply caused by various mechanisms. The hip is the most common affected joint followed by knee. Incidence of AVN in rheumatic diseases is variable and high corticosteroid (CS) therapy is a known major risk factor for development of AVN. Read More

Arthroplast Today 2018 Dec 1;4(4):510-515. Epub 2018 Sep 1.

TEAMHealth Anesthesia Research Institute, Tampa, FL, USA.

Background: Osteonecrosis of the knee (ONK) is a form of aseptic necrosis resulting from ischemia to subchondral bone tissue. Typically, treatment is invasive. Hyperbaric oxygen therapy (HBOT) may provide a noninvasive alternative by improving oxygenation and reperfusion of ischemic areas. Read More

Knee 2018 Dec 14. Epub 2018 Dec 14.

The University of Tokyo Hospital, Orthopaedic surgery, Tokyo, Japan.

Meniscal bearing dislocation while rolling over in sleep has never been reported in Oxford unicompartmental knee arthroplasty (UKA). This study reports two cases of meniscal bearing dislocation into the intercondylar ridge while rolling over in sleep. In the case of one patient, closed reduction of the bearing was performed, and the use of a knee brace was effective in preventing re-dislocation. Read More

Medicine (Baltimore) 2018 Dec;97(50):e13408

Center for Osteonecrosis and Joint Preserving & Reconstruction, Department of Orthopaedic Surgery, China-Japan Friendship Hospital, 2 Yinghuadong Road China.

Unicompartmental knee arthroplasty (UKA) is one of the effective surgical methods for the treatment of unicompartmental knee arthritis. When UKA fails, a revised surgery to total knee arthroplasty (TKA) is often necessary. The purpose of this study was to compare the clinical outcomes of revision of failed UKAs to TKAs with primary TKAs. Read More

Hip Int 2018 Nov 1:1120700018808693. Epub 2018 Nov 1.

1 Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Introduction:: The purpose of this study was to investigate the incidence of necrosis and insufficiency fracture of the hip and knee using magnetic resonance imaging (MRI) in renal transplant patients.

Methods:: We examined 300 consecutive renal transplant patients using MRI of the hips and knees (T1-weighted coronal MRI) preoperatively and at 3 and 6 months postoperatively. Oblique axial-plane T1-weighted MRI and short-tau inversion-recovery T2-weighted MRI were performed parallel to the femoral neck when distinguishing the osteonecrosis of the femoral head (ONFH) from subchondral insufficiency fracture (SIF) of the femoral head was difficult. Read More

Acta Ortop Mex 2018 May-Jun;32(3):163-166

Servicio de Cirugía Ortopédica y Traumatología, Hospital de Sabadell. Institut Universitari Parc Taulí Universitat Autònoma de Barcelona, España.

We present the case of an 81-year-old woman who was followed up by the Rheumatology Service for osteoporosis and treated with bisphosphonates for more than five years. She reported a fracture of the distal third of the contralateral femur by a low energy mechanism, treated with retrograde intramedullary nailing the previous year. She presented a clinic of cruralgia and left gonalgia, without previous trauma. Read More

J Arthroplasty 2018 Nov 12. Epub 2018 Nov 12.

Aix-Marseille University, CNRS, ISM, Institute of Movement Science, Marseille, France; Department of Orthopaedics and Traumatology, APHM, Sainte Marguerite Hospital, Institute for Locomotion, Marseille, France.

Background: Numerous series have documented short and mid-term successes with cemented, metal-backed modern unicompartmental knee arthroplasty (UKA) for avascular osteonecrosis of the knee (AVN). However, data are lacking regarding long-term implant fixation and patient function. The aim of this study is therefore to evaluate the long-term clinical outcome and implant survivorship of patients who underwent UKA for medial knee osteonecrosis (ON). Read More

Radiol Case Rep 2019 Feb 9;14(2):208-212. Epub 2018 Nov 9.

London North West Healthcare NHS Trust, Infectious Diseases Department Ealing Hospital, Uxbridge Road, Southall, Middlesex UB1 3HW, UK.

We present a young man with a background Human Immunodeficiency virus (HIV) who presented with bilateral knee pain and reduced mobility. Subsequent imaging of the knees demonstrated florid osteonecrosis (ON), which was managed conservatively. ON is seen more commonly in HIV patients than the general population, however the underlying mechanism for this association is remains unclear. Read More

Asia Pac J Sports Med Arthrosc Rehabil Technol 2019 Jan 1;15:1-5. Epub 2018 Nov 1.

Department of Orthopedics, Okayama Kyokuto Hospital, 567-1 Kurata, Naka-ku, Okayama, 703-8265, Japan.

Background/objective: Unicompartmental knee arthroplasty (UKA) is a low-invasive knee surgery that enables early recovery. Stress fracture of the medial tibial plateau (MTP) is a complication of UKA that prolongs treatment once it has occurred. We investigated factors affecting its occurrence. Read More

Chin Med J (Engl) 2018 Nov;131(21):2544-2550

Department of Orthopaedics, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, China.

Background: In a small proportion of cases, spontaneous osteonecrosis of the knee (SONK) involves the medial tibial plateau (MT). Here, we introduced the clinical characteristics of spontaneous osteonecrosis of the MT and unicompartmental knee arthroplasty (UKA) as the favorable treatment for this situation based on a retrospective case study.

Methods: Patients with spontaneous osteonecrosis of the MT, confirmed by magnetic resonance imaging (MRI) at Guangdong Provincial Hospital of Chinese Medicine (China) from March 2015 to June 2016, were included as a case serial and analyzed retrospectively. Read More

Cartilage 2018 Oct 31:1947603518809399. Epub 2018 Oct 31.

3 Division of Orthopaedic Surgery, Scripps Clinic, La Jolla, CA, USA.

Objective: No studies currently exist with long-term follow-up of use of osteochondral allografting (OCA) for treatment of steroid-associated osteonecrosis of femoral condyles in young, active patients who wish to avoid total knee arthroplasty (TKA). We evaluate the extent to which fresh osteochondral allografts can (1) prevent or postpone need for prosthetic arthroplasty and (2) maintain long-term clinically meaningful decrease in pain and improvement in function at mean 11-year follow-up.

Design: Twenty-five patients (33 knees) who underwent OCA transplantation for osteonecrosis of the knee between 1984 and 2013 were evaluated, including 22 females and 11 males with average age of 25 years (range, 16-48 years). Read More

Rev Bras Ortop 2018 Nov-Dec;53(6):797-801. Epub 2018 Sep 19.

Serviço de Ortopedia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

Joint preservation surgery is accepted in cases of secondary osteonecrosis of the knee without joint collapse. However, there is no consensus on the best treatment: debridement and drilling, or use of auto- or allograft. The author describes a clinical case with 15 years of evolution where allogeneic osteochondral graft was used in the treatment of osteonecrosis of the lateral femoral condyle in a young woman with systemic lupus. Read More

Plast Reconstr Surg Glob Open 2018 Jun 19;6(6):e1792. Epub 2018 Jun 19.

Hand and Upper Extremity Surgery Department, "Dr Carlos E. Ottolenghi" Orthopaedic Institute, Hospital Italiano de Buenos Aires, Argentina, Ciudad de Buenos Aires, Argentina.

The medial femoral condyle vascularized graft has become a useful resource in reconstructive microsurgery due to the rate of bony union, and the low rate of complication. We report osteonecrosis of the medial femoral condyle in a 65-year-old woman after harvesting a corticocancellous medial femoral condyle graft to treat a tarsometatarsal nonunion. We were not able to define whether a vascular or mechanical disorder could be the ultimate cause. Read More

J Orthop Sports Phys Ther 2018 Oct;48(10):824

A 69-year-old man was referred to physical therapy by his primary care physician for an insidious onset of right medial knee pain that had been present for over 4 weeks. Due to the disproportionate response following initial management, he was referred to an orthopaedist for imaging. Magnetic resonance imaging revealed medial femoral condyle osteopenia, bone marrow edema, and subchondral bone collapse, and subsequently the patient was diagnosed with spontaneous osteonecrosis of the knee. Read More

World Neurosurg 2018 Dec 26;120:500-505. Epub 2018 Sep 26.

Department of Neurosurgery, Nanoori Gangnam Hospital, Seoul, Republic of Korea.

Background: Kummell disease is defined as avascular necrosis of vertebra, occurs after the delayed posttraumatic osteoporotic vertebral collapse, and mainly occurs in adults older than 50 years of age. We report the first case of refracture of Kummell disease and epidural hematoma followed by paraparesis.

Case Description: A 67-year-old woman with a known case of osteoporotic T12 fracture (3 months back) visited our outpatient clinic complaining of persistent back pain and paraparesis after jerking while getting up from the bed. Read More

Orthop J Sports Med 2018 Sep 19;6(9):2325967118798355. Epub 2018 Sep 19.

Department of Orthopaedic Surgery, Boston University School of Medicine, Boston, Massachusetts, USA.

J Orthop Sci 2019 Jan 21;24(1):136-141. Epub 2018 Sep 21.

Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Japan; Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Japan.

Background: There have been some reports of high tibial osteotomy combined with osteochondral autograft transfer for osteonecrosis of the medial femoral condyle of the knee. However, few of them have focused on the deep knee flexion needed to sit straight in the Japanese style.

Purpose: To evaluate the clinical outcomes and the knee flexion of HTO combined with OAT for osteonecrosis of the medial femoral condyle of the knee, especially the ability to sit straight in the Japanese style. Read More

Medicine (Baltimore) 2018 Sep;97(36):e12270

Department of Orthopaedic Surgery, China-Japan Union Hospital of Jilin University Changchun, Jilin, P. R. China.

Background: Blood management after arthroplasties has become a serious problem. The objective is to perform a meta-analysis to compare the efficacy and safety between oral tranexamic acid (TXA) and intravenous TXA for blood management in total knee and hip arthroplasty.

Methods: We systematically searched randomized controlled trials (RCTs) from Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and Google scholar. Read More

Osteoporos Int 2018 Aug 27. Epub 2018 Aug 27.

Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529, Hamburg, Germany.

Raine syndrome is characterized by FGF23-mediated hypophosphatemic osteomalacia with osteosclerosis caused by mutations in the FAM20C gene. We report a case of a 72-year-old man who presented with rapid progressive spontaneous osteonecrosis of the knee (SONK). A full osteologic assessment including dual energy X-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT), and serum analyses revealed a high bone mass in the lumbar spine and hip (DXA T-score + 7. Read More

Eur J Orthop Surg Traumatol 2019 Jan 23;29(1):119-124. Epub 2018 Aug 23.

Department of Orthopedic Surgery, Toho University School of Medicine, 2-17-6 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan.

Purpose: Primary Spontaneous osteonecrosis of the knee (SPONK) was a result of a subchondral insufficiency fracture based on histopathological examinations. There were few studies examining patients who underwent unicompartmental knee arthroplasty (UKA) for the treatment of primary SPONK. The aim of this study was to investigate (1) patient-reported outcome measure (PROM), (2) survivorship of revision as end point and (3) survivorship of complication as end point in patients with primary SPONK. Read More

Radiographics 2018 Sep-Oct;38(5):1478-1495. Epub 2018 Aug 17.

From the Department of Radiology, Einstein Healthcare Network, 5501 Old York Rd, Philadelphia, PA 19141 (T.G, M.C., B.W.C.) and Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala (Y.M.).

Several pathologic conditions may manifest as an osteochondral lesion of the knee that consists of a localized abnormality involving subchondral marrow, subchondral bone, and articular cartilage. Although understanding of these conditions has evolved substantially with the use of high-spatial-resolution MRI and histologic correlation, it is impeded by inconsistent terminology and ambiguous abbreviations. Common entities include acute traumatic osteochondral injuries, subchondral insufficiency fracture, so-called spontaneous osteonecrosis of the knee, avascular necrosis, osteochondritis dissecans, and localized osteochondral abnormalities in osteoarthritis. Read More

J Med Imaging Radiat Oncol 2018 Dec 16;62(6):764-768. Epub 2018 Aug 16.

Radiology Department, Royal Orthopaedic Hospital, NHS Foundation Trust, Northfield, Birmingham, UK.

Introduction: To describe a novel secondary sign of subchondral insufficiency fracture of the knee, metaphyseal burst sign (soft tissue oedema in the meta-epiphyseal region of the affected condyle).

Methods: An electronic database research of 7926 knee MRI examinations was performed. Forty-eight scans were included in the study. Read More

Orthopade 2018 Sep;47(9):777-781

UniversitätsCentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Carl Gustav Carus, Dresden, Deutschland.

Total knee arthroplasty (TKA) is one of the most frequent surgical procedures in orthopaedic surgery. Until now there have not been any standardized indication criteria, which might contribute to the large geographical differences in the frequency of TKA. This guideline aims to consent minimal requirements (main criteria), additional important aspects (minor criteria), as well as relative and absolute contraindications for TKA. Read More

J Orthop Sci 2018 Jul 25. Epub 2018 Jul 25.

Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.

Medicine (Baltimore) 2018 Jul;97(30):e11290

Centre for Osteonecrosis and Joint-preserving & Reconstruction, Orthopaedic Department, China-Japan Friendship Hospital, Chaoyang District.

Background: Placement of closed suction drains after total knee arthroplasty is an age-old practice; however, benefits and disadvantages of this procedure remain disputable in various studies.

Methods: We performed an electronic database search in Medline/PubMed, the Cochrane Library, and Embase to retrieve publications with respect to this issue and then screened reference lists of related articles manually to obtain any additional ones. Randomized controlled trials (RCTs) evaluating the use of closed suction drains after primary total knee arthroplasty were eligible for this study. Read More

EFORT Open Rev 2018 06 6;3(6):363-373. Epub 2018 Jun 6.

Department of Orthopaedic Surgery, La Paz University Hospital - IdiPaz, Spain.

An age younger than 60 years, a body weight of 180 lb (82 kg) or more, performing heavy work, having chondrocalcinosis and having exposed bone in the patellofemoral (PF) joint are not contraindications for unicompartmental knee arthroplasty (UKA).Severe wear of the lateral facet of the PF joint with bone loss and grooving is a contraindication for UKA.Medial UKA should only be performed in cases of severe osteoarthritis (OA) as shown in pre-operative X-rays, with medial bone-on-bone contact and a medial/lateral ratio of < 20%. Read More

Orthop Traumatol Surg Res 2018 Jul 7. Epub 2018 Jul 7.

Université de Lille Nord de France, 59037 Lille, France; Service d'orthopédie, hôpital Roger-Salengro, centre hospitalier régional universitaire de Lille, place de Verdun, 59037 Lille, France.

Patellar complications are a source of poor total knee arthroplasty (TKA) outcomes that can require re-operation or prosthetic revision. Complications can occur with or without patellar resurfacing. The objective of this work is to answer six questions. Read More

Br J Radiol 2018 Oct 11;91(1090):20180168. Epub 2018 Sep 11.

1 Department of Nuclear Medicine, Guy's and St Thomas' Hospital NHS Foundation Trust , London , UK.

Objective:: To assess the role of single photon emission computed tomography (SPECT/CT) in the evaluation of knee pain as well as comparing bone scintigraphy (BS), SPECT and SPECT/CT, and assessing the incremental value of SPECT/CT.

Methods:: BS, SPECT and SPECT/CT of patients with knee pain (39 patients, 65 knees, 105 lesions) were directly compared for lesion detection, localisation and characterisation using lesion-based, knee-based and patient-based analyses in this retrospective study.

Results:: Lesion detection: BS (91. Read More

Int Orthop 2018 Jul 7;42(7):1755-1767. Epub 2018 Jun 7.

Laboratory of Bone and Metabolic Biochemistry, Faculty of Medicine, Université libre de Bruxelles, Brussels, Belgium.

Introduction: Human spontaneous osteonecrosis of the knee (SPONK) is still challenging as the current treatments do not allow the production of hyaline cartilage tissue. The aim of the present study was to explore the therapeutic potential of cartilage regeneration using a new biphasic scaffold (type I collagen/hydroxyapatite) previously loaded or not with concentrated bone marrow cells.

Material And Methods: Female rabbits were operated of one knee to create articular lesions of the trochlea (three holes of 4 × 4mm). Read More

BMC Musculoskelet Disord 2018 May 22;19(1):158. Epub 2018 May 22.

Health Science Institute, Federal University of Bahia, Av. Reitor Miguel Calmon, s/n, Vale do Canela, Salvador, BA, 40110-100, Brazil.

Background: The purpose of our study was to evaluate safety, feasibility and clinical results of bone marrow mononuclear cell (BMC) implantation for early-stage osteonecrosis of the knee (OK) secondary to sickle cell disease.

Methods: Thirty-three SCD patients (45 knees) with OK treated with BMC implantation in the osteonecrotic lesion were clinically and functionally evaluated through the American Knee Society Clinical Score (KSS), Knee Functional Score (KFS) and Numeric Rating Scale (NRS) pain score. MRI and radiographic examinations of the knee were assessed during a period of five years after intervention. Read More

Knee 2018 Aug;25(4):715-721

Department of Orthopedic Surgery and Joint Surgery Center, Takatsuki General Hospital, Takatsuki, Osaka, Japan.

Background: There have been very few reports on isolated medial tibial plateau osteonecrosis, and the condition has not been clearly described. Unicompartmental knee arthroplasty (UKA) may be an appropriate treatment method for this condition. The aims of this study were to report our experience of using mobile-bearing knee implants for osteonecrosis of the medial tibial plateau and to discuss the etiology and treatment of this type of osteonecrosis. Read More

Clin Orthop Relat Res 2018 Jun;476(6):1324-1338

A. B. Lovati, M. Bottagisio, Cell and Tissue Engineering Laboratory, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy S. Maraldi, C. L. Romanò, Dipartimento di Chirurgia Ricostruttiva e delle Infezioni Osteo-articolari, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy M. B. Violatto, P. Bigini, Nanobiology Unit, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy M. Bortolin, E. De Vecchi, L. Drago, Laboratory of Clinical Chemistry and Microbiology, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy L. Drago, Department of Biomedical Science for Health, University of Milan, Milan, Italy.

Background: Implant-related infections are associated with impaired bone healing and osseointegration. In vitro antiadhesive and antibacterial properties and in vivo antiinflammatory effects protecting against bone loss of various formulations of vitamin E have been demonstrated in animal models. However, to the best of our knowledge, no in vivo studies have demonstrated the synergistic activity of vitamin E in preventing bacterial adhesion to orthopaedic implants, thus supporting the bone-implant integration. Read More

Prim Care 2018 Jun;45(2):289-303

Rheumatology Fellowship, San Antonio Uniformed Services Health Education Consortium (SAUSHEC), Uniformed Services University of the Health Sciences, San Antonio Military Medical Center, 3551 Roger Brooke Drive, San Antonio, TX 78234, USA.

Soft tissue musculoskeletal pain disorders are common in the primary care setting. Early recognition and diagnosis of these syndromes minimizes patient pain and disability. This article gives a brief overview of the most common soft tissue musculoskeletal pain syndromes. Read More

Acta Orthop Traumatol Turc 2018 May 5. Epub 2018 May 5.

Department of Orthopaedic Surgery, Ewha Womans University School of Medicine, Seoul, South Korea. Electronic address:

We present a case of osteonecrosis of bipartite patella occurring after total knee arthroplasty using medial parapatellar approach without lateral retinacular release in osteoarthritic knee of a 66 year-old-male. The surgery was performed using traditional technique with medial parapatellar approach and patella was resurfaced. Patella was everted during surgery. Read More

Medicine (Baltimore) 2018 May;97(18):e0587

Center for Osteonecrosis and Joint-preserving and Reconstruction, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, Peking Union Medical College, National Health and Family Planning Commission of the People's Republic of China, Beijing, China.

Background: Tranexamic acid (TXA) is an antifibrinolytic drug widely used as a blood-sparing technique in total knee arthroplasty (TKA), and it is usually administrated by intravenous or intraarticular injection. Recently, the oral form of TXA has been applied in TKA patients. However, there is no final consensus regarding the effectiveness and safety of oral TXA. Read More

J Orthop Surg (Hong Kong) 2018 May-Aug;26(2):2309499018770927

3 Department of Hip and Knee Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Purpose: Oxidative stress is closely associated with the pathogenesis of nontraumatic osteonecrosis of the femoral head (ONFH). This study aimed to determine whether the serum levels of antioxidant nutrients were decreased in patients with ONFH.

Methods: We analyzed the serum levels of antioxidant nutrients in 39 patients with ONFH (ONFH group) and 78 age- and gender-matched healthy people (control group) who voluntarily participated in the Yakumo study, which is a comprehensive health examination program. Read More

J Orthop Surg (Hong Kong) 2018 May-Aug;26(2):2309499018770925

1 Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA.

Background: Spontaneous osteonecrosis of the knee (SONK) is a poorly understood but debilitating disease entity. Total knee arthroplasty (TKA) is the standard of care for those patients who fail conservative management, but considering SONK's predilection for affecting a single knee compartment, unicompartmental knee arthroplasty (UKA) appears to be a more tailored option. Unfortunately, conflicting data exist on the utility of UKA in SONK. Read More

Knee Surg Sports Traumatol Arthrosc 2018 Nov 16;26(11):3468-3473. Epub 2018 Apr 16.

Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.

Purpose: This study aimed to determine the correlation between the change in joint line height calculated from the resected bone and insert thickness during surgery and the change in limb alignment following unicompartmental knee arthroplasty (UKA). It was hypothesized that joint line elevation is correlated with the change in limb alignment.

Methods: A total of 74 consecutive patients diagnosed with either isolated medial compartmental osteoarthritis (38 patients) or spontaneous osteonecrosis of the knee (36 patients) were included. Read More

Bone Joint J 2018 04;100-B(4):450-454

Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA.

Aims: Primary (or spontaneous) and secondary osteonecrosis of the knee can lead to severe joint degeneration, for which either total or unicompartmental arthroplasty may be considered. However, there are limited studies analyzing outcomes of unicompartmental knee arthroplasties (UKAs) for osteonecrosis involving an isolated compartment of the knee. The aims of this study were to analyze outcomes of UKAs for osteonecrosis with specific focus on 1) survivorship free of any revision or reoperation, 2) risk factors for failure, 3) clinical outcomes, and 4) complications. Read More

Surg Technol Int 2018 06;32:263-269

Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.

Background: Although there are studies regarding immunosuppressed patients undergoing total knee arthroplasty (TKA) for inflammatory arthritis or osteonecrosis, there is a paucity of studies evaluating immunosuppressed patients undergoing TKA for diagnoses other than these.

Materials And Methods: We identified all patients undergoing primary TKA for osteoarthritis from 2008-2014 in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Overall, 111,624 patients were included. Read More

Int Orthop 2018 Nov 27;42(11):2563-2571. Epub 2018 Mar 27.

Hôpital Henri Mondor, 94010, Creteil, France.

Purpose: Total knee arthroplasty (TKA) implanted in patients with secondary osteonecrosis (ON) related to corticosteroids have relatively poor outcome (20% revision rate) at a mean follow-up of only eight years. With the hypothesis that subchondral bone marrow injection might improve knees in these patients, we evaluated 30 patients who had bilateral knee osteoarthritis with severe joint space narrowing and received TKA in one knee and subchondral bone marrow concentrate injection in the contralateral knee.

Material And Methods: A prospective randomized controlled clinical trial was carried out in 60 knees of 30 patients (mean age 28 years, 18-41) who presented bilateral osteoarthritis secondary to knee ON related to corticosteroids in relation with different severe medical conditions. Read More

Int Orthop 2018 Jul 26;42(7):1527-1534. Epub 2018 Mar 26.

Health Science Institute, Federal University of Bahia, Av. Reitor Miguel Calmon, s/n, Vale do Canela, Salvador, BA, 40110-100, Brazil.

Purpose: The aim of this study was to describe the clinical features of osteonecrosis (ON) in sickle cell disease (SCD) patients in Bahia, a Northeast state with the highest prevalence of the disease in Brazil.

Methods: Between 2006 and 2017, 283 cases of osteonecrosis in SCD patients were enrolled to analyse the age at diagnosis, genotype, gender, pain, distribution of the lesions and disease staging. MRI and radiograph were obtained at the participation. Read More

Int Orthop 2018 Jul 18;42(7):1499-1508. Epub 2018 Mar 18.

Department of Orthopedics, All India Institute of Medical Sciences, Saket Nagar, Habib Ganj, Bhopal, Madhya Pradesh, 462026, India.

Purpose: Spontaneous osteonecrosis of the knee affects the medial femoral condyle in patients above 55 years of age. Many reports and studies are available from western countries. But there is a gross paucity of literature on spontaneous osteonecrosis of the knee (SPONK) in the Indian subcontinent, either it is under-reported or detected at a later stage. Read More

Int Orthop 2018 Jul 9;42(7):1463-1468. Epub 2018 Mar 9.

Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.

Purposes: The objectives of this study were to investigate patient-reported outcomes and referral pain at the first visit in patients with osteonecrosis of the femoral head (ONFH) and to clarify the influence of collapse of the femoral head and the contralateral condition.

Methods: The study included 105 patients (130 hips) with ONFH at the first visit, who were divided into two groups based on the presence of bilateral walking hip pain (bilateral group 25 patients, 50 hips) and unilateral hip pain (unilateral group 80 patients, 80 hips). We compared the Short Form-36 (SF-36), Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ), and visual analog scale (VAS) responses for hip, knee, and low back pain between the groups to investigate the influence of the contralateral condition. Read More

Rheumatology (Oxford) 2018 05;57(5):844-849

Department of Orthopaedic Surgery, St Marianna University School of Medicine, Kanagawa, Japan.

Objective: The purpose of this study was to investigate transitional changes in the incidence of glucocorticoid-associated osteonecrosis in SLE patients, with a focus on immunosuppressive agent and glucocorticoid consumption.

Methods: We retrospectively registered 185 SLE patients with 740 joints, who were newly diagnosed and hospitalized for initial high-dose glucocorticoid therapy from 1986 to 2015. Immunosuppressive agent, glucocorticoid dose, age, sex, organ lesion at hospitalization, complement (C3, C4, CH50) and anti-DNA antibody before initial glucocorticoid therapy, the frequency of use of anticoagulant and antilipidemic drugs, and incidence of osteonecrosis were documented. Read More

J Orthop Sci 2018 May 17;23(3):521-524. Epub 2018 Feb 17.

Department of Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, 1-3-13 Kosobe-cho, Takatsuki-shi, Osaka, 569-1192, Japan.

Background: Despite the fact that multiple screw fixation is a common option of surgical treatment for femoral neck fractures, there is a paucity of precise morphological study of the femoral neck. To identify appropriate positions and spacing of hip screws for multiple-screw femoral neck fracture fixation, proximal femur morphology in Japanese patients was studied.

Method: One hundred hips in fifty knee arthroplasty candidates were studied. Read More

Zhongguo Gu Shang 2017 Nov;30(11):1074-1076

Osteonecrosis and Joint Reconstruction Ward, Department of Joint Surgery, Xi'an Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China;

Fabella is a common sesamoid bone. In recent years, people have paid more attention to its anatomic location, distribution characteristics in crow, importance in stabilizing knee joint and related diseases. This article reviews the anatomy, distribution and the relationship between the calf bone and the knee joint diseases, so as to strengthen the attention of the bones in the diagnosis and treatment of knee diseases. Read More

Surg Technol Int 2017 Dec;31:374-378

Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.

Knee osteonecrosis is a rare, yet debilitating disease that can lead to knee joint destruction and can be associated with significant pain and disability. Various imaging modalities have different roles in the diagnosis, staging, management, and determination of the prognosis in knee osteonecrosis. Plain radiographic images can show gross joint destruction and secondary arthritic changes. Read More